NPI | 1043895956 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95016747) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA 95016747) |
Enumeration Date | 2021-03-11 |
Last Update Date | 2023-01-18 |